Non-small cell lung cancer in ever-smokers vs never-smokers
Abstract Background Lung cancer is a leading cause of cancer-related mortality. Non-small cell lung cancer (NSCLC) comprises 85% of cases with rising incidence among never-smokers (NS). This study seeks to compare clinical, imaging, pathology, and outcomes between NS and ever-smokers (S) NSCLC patie...
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2025-01-01
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| Online Access: | https://doi.org/10.1186/s12916-024-03844-8 |
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| author | Jeremy R. Burt Naim Qaqish Greg Stoddard Amani Jridi Parker Sage Anderson Lacey Woods Anna Newman Malorie R. Carter Reham Ellessy Jordan Chamberlin Ismail Kabakus |
| author_facet | Jeremy R. Burt Naim Qaqish Greg Stoddard Amani Jridi Parker Sage Anderson Lacey Woods Anna Newman Malorie R. Carter Reham Ellessy Jordan Chamberlin Ismail Kabakus |
| author_sort | Jeremy R. Burt |
| collection | DOAJ |
| description | Abstract Background Lung cancer is a leading cause of cancer-related mortality. Non-small cell lung cancer (NSCLC) comprises 85% of cases with rising incidence among never-smokers (NS). This study seeks to compare clinical, imaging, pathology, and outcomes between NS and ever-smokers (S) NSCLC patients to identify significant differences if any. Methods Retrospective cohort study of 155 NSCLC patients (88 S and 67 NS). The main predictor was smoking. Clinical, imaging, and pathology findings were evaluated at initial biopsy for staging. The primary outcome was all-cause mortality, and the secondary outcome was 12-month progression-free survival. Results Imaging: NS and S had similar nodule size (0.81), calcification (> 0.99), and invasion of adjacent structures (> 0.99) (p values). NS slightly trended to more commonly involve the RLL vs S the RUL (p = 0.11). NS had higher numbers of extrathoracic metastases at initial biopsy for staging (p = 0.055). Pathology: NS more commonly had adenocarcinoma compared to S, who had equal numbers of adenocarcinoma and squamous cell carcinoma (p = 0.001). Rates of lymphovascular and pleural invasion were similar (p = 0.84 and 0.28). Initial staging: NS were more often initially diagnosed with stage IV disease (p = 0.046), positive nodal disease (p = 0.002), and metastatic disease (p = 0.004). Outcomes: S had a non-significant trend toward worse 12-month progression-free survival (rate ratio = 1.31, p = 0.31; HR = 1.33, p = 0.28). NS and S had similar 1-year all-cause mortality (HR = 1.06, p = 0.90). S had nearly double the risk of all-cause mortality in 5 years (HR = 1.73, p = 0.056) and 10 years (HR = 1.77, p = 0.02). Median survival was 6.6 years for NS and 3.9 years for S, with NS surviving 2.7 years longer on average (p = 0.045). Conclusions CT nodule features were similar in NS and S. NS more often had metastatic adenopathy, distant metastases, and stage IV disease at initial biopsy. Despite similar 12-month progression-free survival and 1-year all-cause mortality, S had nearly double the risk of mortality in the first 5 and 10 years post-diagnosis. Trial registration Retrospectively registered. |
| format | Article |
| id | doaj-art-f3f86836a39b4d0cbea9c7ca23cb2d6e |
| institution | Kabale University |
| issn | 1741-7015 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Medicine |
| spelling | doaj-art-f3f86836a39b4d0cbea9c7ca23cb2d6e2025-01-12T12:26:55ZengBMCBMC Medicine1741-70152025-01-0123111410.1186/s12916-024-03844-8Non-small cell lung cancer in ever-smokers vs never-smokersJeremy R. Burt0Naim Qaqish1Greg Stoddard2Amani Jridi3Parker Sage Anderson4Lacey Woods5Anna Newman6Malorie R. Carter7Reham Ellessy8Jordan Chamberlin9Ismail Kabakus10Department of Radiology, Cardiothoracic Imaging, University of Utah, Spencer Fox Eccles School of MedicineDepartment of Radiology, Cardiothoracic Imaging, University of Utah, Spencer Fox Eccles School of MedicineDepartment of Biomedical Informatics, University of UtahDepartment of Biomedical Informatics, University of UtahSpencer Fox Eccles School of Medicine, University of UtahSpencer Fox Eccles School of Medicine, University of UtahSpencer Fox Eccles School of Medicine, University of UtahSpencer Fox Eccles School of Medicine, University of UtahUniversity of Utah HealthDepartment of Radiology, Medical University of South CarolinaDepartment of Radiology, Medical University of South CarolinaAbstract Background Lung cancer is a leading cause of cancer-related mortality. Non-small cell lung cancer (NSCLC) comprises 85% of cases with rising incidence among never-smokers (NS). This study seeks to compare clinical, imaging, pathology, and outcomes between NS and ever-smokers (S) NSCLC patients to identify significant differences if any. Methods Retrospective cohort study of 155 NSCLC patients (88 S and 67 NS). The main predictor was smoking. Clinical, imaging, and pathology findings were evaluated at initial biopsy for staging. The primary outcome was all-cause mortality, and the secondary outcome was 12-month progression-free survival. Results Imaging: NS and S had similar nodule size (0.81), calcification (> 0.99), and invasion of adjacent structures (> 0.99) (p values). NS slightly trended to more commonly involve the RLL vs S the RUL (p = 0.11). NS had higher numbers of extrathoracic metastases at initial biopsy for staging (p = 0.055). Pathology: NS more commonly had adenocarcinoma compared to S, who had equal numbers of adenocarcinoma and squamous cell carcinoma (p = 0.001). Rates of lymphovascular and pleural invasion were similar (p = 0.84 and 0.28). Initial staging: NS were more often initially diagnosed with stage IV disease (p = 0.046), positive nodal disease (p = 0.002), and metastatic disease (p = 0.004). Outcomes: S had a non-significant trend toward worse 12-month progression-free survival (rate ratio = 1.31, p = 0.31; HR = 1.33, p = 0.28). NS and S had similar 1-year all-cause mortality (HR = 1.06, p = 0.90). S had nearly double the risk of all-cause mortality in 5 years (HR = 1.73, p = 0.056) and 10 years (HR = 1.77, p = 0.02). Median survival was 6.6 years for NS and 3.9 years for S, with NS surviving 2.7 years longer on average (p = 0.045). Conclusions CT nodule features were similar in NS and S. NS more often had metastatic adenopathy, distant metastases, and stage IV disease at initial biopsy. Despite similar 12-month progression-free survival and 1-year all-cause mortality, S had nearly double the risk of mortality in the first 5 and 10 years post-diagnosis. Trial registration Retrospectively registered.https://doi.org/10.1186/s12916-024-03844-8Non-small cell lung cancerChest CTHistopathologyCancer stagingAll-cause mortality |
| spellingShingle | Jeremy R. Burt Naim Qaqish Greg Stoddard Amani Jridi Parker Sage Anderson Lacey Woods Anna Newman Malorie R. Carter Reham Ellessy Jordan Chamberlin Ismail Kabakus Non-small cell lung cancer in ever-smokers vs never-smokers BMC Medicine Non-small cell lung cancer Chest CT Histopathology Cancer staging All-cause mortality |
| title | Non-small cell lung cancer in ever-smokers vs never-smokers |
| title_full | Non-small cell lung cancer in ever-smokers vs never-smokers |
| title_fullStr | Non-small cell lung cancer in ever-smokers vs never-smokers |
| title_full_unstemmed | Non-small cell lung cancer in ever-smokers vs never-smokers |
| title_short | Non-small cell lung cancer in ever-smokers vs never-smokers |
| title_sort | non small cell lung cancer in ever smokers vs never smokers |
| topic | Non-small cell lung cancer Chest CT Histopathology Cancer staging All-cause mortality |
| url | https://doi.org/10.1186/s12916-024-03844-8 |
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